Mathematically modeling worried-well behavior during infectious disease outbreaks

Ethical considerations are important in pandemic preparedness and response, however, there is a noticeable scarcity of ethical codes that are tailored to disease outbreaks and health emergencies. To document the development of guidelines for ethical management of infectious disease outbreaks in Islamic Republic of Iran, as a model for low- and middle-income countries. We conducted a non-systematic scoping review on PubMed and Google Scholar for drafting the guidelines for ethical management of infectious disease outbreaks in Islamic Republic of Iran. The draft was discussed and revised following consultations with different groups of experts and the Medical Ethics Council of the Iranian Academy of Medical Sciences. The joint assembly of the National Clinical Ethics Committee and the Supreme Council of Medical Ethics endorsed and introduced the revised document as official guidelines for ethical response to infectious disease outbreaks in Islamic Republic of Iran. The guidelines were based on a set of core values and principles: human dignity, liberty, maximizing benefits and minimizing risks, and justice and transparency. In 3 distinct sections, the document provides ethical guidance for healthcare system management and leadership; provision of health services; and for education, research and use of technology during health emergencies. The guidelines have been very useful in responding ethically to the COVID-19 pandemic, there may be a need to adapt some of the recommendations for optimum benefits in specific contexts. It is necessary to create awareness of the existence of the document and educate healthcare professionals about its importance so they can apply the recommendations in their practice.

The impact of climate change and global warming are worldwide and global concern. Bangladesh is unfortunately home to many infectious diseases. Climate change related events like temperature, rainfall, humidity etc. have direct and indirect adverse impacts on the outbreak of infectious disease among children. A number of water, air and vector borne infectious diseases including diarrhoea, measles, rubella, kala-azar, malaria and dengue etc. are common in Bangladesh. A cross sectional study was carried out to observe the impact of climate factors on the incidence of air borne infectious disease among children in Bangladesh. The methodology of the study includes analysis of both secondary and primary data. Results showed the long-term changes of annual mean, maximum and minimum temperature of study area over the study period (1964-2011) found to have in general increasing trends in annual mean and annual mean minimum temperature but the mean maximum temperature slightly rising in recent past decades. Seasonal mean temperatures are also found to have increased trend. The long-term changes in annual rainfall that showed declining trend. Seasonal rainfalls also showed markedly reduced in winter and post autumn season. The primary data reveals that temperature is the main and rainfalls comes next as influencing factor for air borne measles like disease and their outbreak among children. The incidence of measles like disease was found positive correlation with maximum temperature and negatively correlated with average minimum temperature and total annual rainfalls. However, the current understanding of the impact of climate change on the outbreak of air borne infectious disease is not sufficient. To address the existing and future impact of climate change on the outbreak of infectious diseases among children, climate sensitive infectious disease surveillance and continuous monitoring to be considered and further studies are needed.

ObjectivesRespiratory infectious disease outbreaks pose a threat for loss of life, economic instability and social disruption. We conducted a systematic review of published econometric analyses to assess the direct and...

In Chapter Two, Davies walks the reader through the political context of Southeast Asia in relation to the management of infectious disease outbreaks In Chapter Five, Davies impressively surveys surveillance reports relating to the ASEAN states from 1996 to 2010, thereby tracking the changing performance in disease surveillance and response during this period In Chapter One, Davies provides a historical account of the negotiation and adoption in 2005 of the revised International Health Regulations (IHR), described as "a significant diplomatic coup for the WHO" (p 16) [Extracted from the article] Copyright of Singapore Journal of Tropical Geography is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

The handling of the dead bodies caused by the epidemic is one of the methods used to control disease outbreaks. The handling of the dead bodies itself has always been regulated in Article 16 of Government Regulation Number 40 of 1991 about Disease Outbreak Management, way before the COVID-19 pandemic happened. The purpose of this paper is to contribute to the advancement of legal science by expanding knowledge and providing references, particularly in the case of the rejection of COVID-19 victims' bodies, which is the subject of Ungaran District Court Ruling number 76/Pid.Sus/2020/PN Unr. This research is focused on these two problems: the legal review of the funeral law and the rejection of a deceased COVID-19 victim's funeral; and the judges’ consideration in deciding the case of the rejection of a deceased COVID-19 victim's funeral. Objectively, this research aims to describe the legal review of funerals and the rejection of a deceased COVID-19 victim's funeral, as well as the judges' considerations in deciding the case of the rejection of a deceased COVID-19 victim's funeral. The research was conducted using a normative juridical method with a statutory and conceptual approach. Primary and secondary legal materials are discussed and researched using an interpretation method with the aim of providing clarity on the existing legal materials related to the problems encountered. As such, the research results were as follows: Firstly, there are adequate laws and regulations for funeral management, including protocols for the burial of bodies due to infectious disease outbreaks. Refusing to bury a deceased COVID-19 victim is a penal act, both according to Law No. 4 of 1984 concerning Outbreaks of Infectious Diseases and the Criminal Code, and is an unlawful act according to Article 1365 of the Civil Code. Second, it was found that the judges decided the case by considering the law, the action, the mental attitude or guilt, and the penality. It is expected that there will be effective public education about the human rights inherent in a person even after death, as well as education about the dangers of stigmatizing COVID-19 patients and victims in efforts to combat the pandemic.

Hydrometeorological hazards comprise a wide range of events, mainly floods, storms, droughts, and temperature extremes. Floods account for the majority of the related disasters in both developed and developing countries. Flooding alters the natural balance of the environment and frequently establish a favorable habitat for pathogens and vectors to thrive. Diseases caused by pathogens that require vehicle transmission from host to host (waterborne) or a host/vector as part of their life cycle (vector-borne) are those most likely to be affected by flooding. Considering the most notable recent destructive floods events of July 2021 that affected several Central Europe countries, we conducted a systematic literature review in order to identify documented sporadic cases and outbreaks of infectious diseases in humans in Europe, where hydrometeorological hazards, mainly floods, were thought to have been involved. The occurrence of water-, rodent-, and vector-borne diseases in several European countries is highlighted, as flooding and the harsh post-flood conditions favor their emergence and transmission. In this context, strategies for prevention and management of infectious disease outbreaks in flood-prone and flood-affected areas are also proposed and comprise pre- and post-flood prevention measures, pre- and post-outbreak prevention measures, as well as mitigation actions when an infectious disease outbreak finally occurs. Emphasis is also placed on the collision of floods, flood-related infectious disease outbreaks, and the evolving COVID-19 pandemic, which may result in unprecedented multi-hazard conditions and requires a multi-hazard approach for the effective disaster management and risk reduction.

Background. The issue of outbreaks of infectious diseases in healthcare facilities is not often discussed in the scientific community. Several years ago, the primary etiological agents of outbreaks in hospitals were bacteria, whereas in most cases under modern conditions, outbreak incidence is caused by viruses.
 Aim. Based on the analysis of research materials on outbreaks of infectious diseases in healthcare facilities of Ural and Siberian Federal Districts, this work aimed to characterize infectious diseases under contemporary conditions and identify problematic issues of the preanalytical stage of epidemiological diagnostics and the organization of preventive and anti-epidemic measures.
 Methods. The data of federal statistical monitoring form No. 23 Information on outbreaks of infectious diseases (18 units of information) and the copy of the Acts of an epidemiological investigation of foci of infectious (parasitic) diseases with the establishment of a causal relationship (14 units of information) were analyzed. The work used epidemiological and statistical methods of information processing. The significance of differences between the indices of independent samples was evaluated using Fishers exact test.
 Results. In 2018, 14 outbreaks of infectious diseases were recorded in healthcare facilities in 7 out of 18 subjects in Ural and Siberian Federal Districts. The total number of victims was 183 people (97 (53.0%) children and 86 (47.0%) adults). Most of the outbreaks (12 of 14; 85.7%) were of viral etiology. One outbreak was of bacterial, and one was of fungal origin.
 Discussion. Viruses played a key role in the formation of foci with multiple diseases in the healthcare facilities of Ural and Siberian Federal Districts in 2018. Most of the foci of infection with an aerogenic transmission mechanism were caused by varicella-zoster virus, and those with fecaloral transmission mechanism were etiologically associated with Norwalk virus. Children were the most vulnerable contingents in outbreaks in the healthcare facilities. In all the situations analyzed, the prerequisites for an outbreak include the untimely isolation of the source of infection, hospital overload, and inadequate financial and logistical support. Anti-epidemic measures were conducted to the fullest extent during outbreaks of acute intestinal infections in comparison with outbreaks of a different etiology.
 Conclusion. Most outbreaks registered in the hospitals could be prevented by vaccination of the related population.

Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks. We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks. A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation. Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self-care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.

Background: The incidence, outbreak frequency, and distribution of many infectious diseases are generally expected to change as a consequence of climate change, yet there is limited regional information available to guide decision making.Objective: We surveyed government officials designated as Competent Bodies for Scientific Advice concerning infectious diseases to examine the degree to which they are concerned about potential effects of climate change on infectious diseases, as well as their perceptions of institutional capacities in their respective countries.Methods: In 2007 and 2009/2010, national infectious disease experts from 30 European Economic Area countries were surveyed about recent and projected infectious disease patterns in relation to climate change in their countries and the national capacity to cope with them.Results: A large majority of respondents agreed that climate change would affect vector-borne (86% of country representatives), food-borne (70%), water-borne (68%), and rodent-borne (68%) diseases in their countries. In addition, most indicated that institutional improvements are needed for ongoing surveillance programs (83%), collaboration with the veterinary sector (69%), management of animal disease outbreaks (66%), national monitoring and control of climate-sensitive infectious diseases (64%), health services during an infectious disease outbreak (61%), and diagnostic support during an epidemic (54%).Conclusions: Expert responses were generally consistent with the peer-reviewed literature regarding the relationship between climate change and vector- and water-borne diseases, but were less so for food-borne diseases. Shortcomings in institutional capacity to manage climate change vulnerability, identified in this assessment, should be addressed in impact, vulnerability, and adaptation assessments.

At first blush, an outbreak of mouse hepatitis virus or epizootic diarrhea of infant mice virus in a research colony of laboratory mice may not seem like a “disaster.” However, irrespective of magnitude, such an outbreak at an academic institution is disruptive for researchers at all levels. It can be a disaster for the graduate student who may have just a few experiments to finish before writing the thesis or for the postdoctoral fellow who is in the lab for only 1 or 2 years. Infectious disease outbreaks also limit the ability of principal investigators to share their animals with collaborators at their home institution as well as with those at extramural sites, thereby thwarting the expectation that research materials supported by federal funds will be made readily available to colleagues. This article traces the evolution of a change in “culture” at a large, well-funded academic institution with over 1,800 active IACUC protocols, more than 1,000 of which include mice. During a period of less than 5 years, the institution evolved from virtual paralysis in the face of such outbreaks to the implementation of policies and practices that enable effective outbreak management and the timely resumption of research functionality. This evolution required not only support from the highest levels of leadership in the university and its school of medicine but also a huge outlay of financial resources.

Starbuck et al. have identified a significant gap in any future global response to a severe influenza pandemic.1 The threat of inadequate preparedness and limited public health responses in low-resource settings, leading to uncontrolled transmission is a real and unwelcome possibility during a pandemic. The authors recommend that detailed authoritative guidance should be developed for low-resource settings and that support should be given to governments in these settings to adapt and implement these guidelines. However, an appropriate public health response and effective management of cases depend primarily on early detection of suspected cases. This remains a major challenge in many developing countries, but syndromic surveillance offers a potential solution in these settings. A novel and visionary system, using a simple but standardised set of symptoms, was first developed by T. Jacob John in the early 1980s in Southern India.2 The system utilised a district-level disease surveillance system in a low-resource setting, to control and limit disease outbreaks through early detection. This approach was further adapted in a rural African setting with a focus on rural hospitals reporting presentations of nine core clinical syndromes, including cholera and meningitis-like disease to ensure early identification of infectious disease outbreaks.3 A similar syndromic surveillance system for outbreak detection and response has recently been implemented in Pacific Island Countries and Territories (PICTs). In 2010, PICTS agreed to develop a regional standardised, simple and sustainable event-based syndromic surveillance system to ensure compliance with IHR requirements (rapid outbreak detection, information sharing and response to outbreaks).3 Health resources vary across the region that includes a number of countries that are categorised as least developed countries (LDC). The system is based on the early detection and reporting of four core syndromes (influenza-like illness, diarrhoea, prolonged fever and acute fever with rash) and the immediate reporting of unusual events. The system uses standardised case definitions and processes rather than focussing on a technology platform used to collect or analyse the data. A Pacific Outbreak Manual has been developed as an integral component of the system; to ensure that health workers have rapid access to robust and practical guidelines on the clinical and public health management of infectious disease outbreaks, including influenza-like illness, and triggers for action.4 This provides PICTs with authoritative guidance on appropriate response measures during a severe influenza pandemic. A recent evaluation highlighted the need for standardised surveillance to help meet IHR obligations and to ensure early warning of infectious disease outbreaks across the Pacific.5 While there is variation in system implementation, it is apparent that this is a strength in a region that includes low-resource communities. Despite differences in personnel resources, medical informatics systems and processes, PICTs have productively participated in and contributed to a regional early warning system. The syndromic surveillance system expanded from six to twenty participating PICTs within 1 year, indicating a high level of acceptance of the system. While there are remaining challenges in ensuring uniform data quality, the system has proven effective in detecting outbreaks, its simplicity and the standardisation of both case definitions and responses are key elements in its usefulness. Detection of future influenza pandemics or other emerging infectious disease outbreaks in the South Pacific should be greatly assisted by this syndromic surveillance system. Syndromic surveillance is particularly useful in settings where access to laboratory diagnosis is not timely, allowing containment measures to be implemented prior to having a definitive diagnosis. However, there are inherent limitations in a system based purely on syndromes due to the broad range of diseases that may cause certain syndromes, including influenza-like illness. To avoid exhausting public health resources on ‘syndrome noise’, it is important to select syndromes carefully for their relative public health importance and to establish local thresholds for response. It is important to reach prior agreement on the number of specimens that need to be sent from a particular area for laboratory confirmation at reference laboratories, to allow syndromic surveillance to serve as an efficient early warning system for a severe influenza pandemic. Simplified syndromic surveillance should be a priority in countries with limited public health system or technological capacity.

In light of the current evolving coronavirus disease 2019 (COVID-19) pandemic, and the need to learn from past infectious disease outbreaks to provide better psychological support for our frontline health care workers (HCW), we conducted a rapid review of extant studies that have reported on both psychological and coping responses in HCW during recent outbreaks. We performed a systematic search of the available literature using PubMed, MEDLINE (Ovid), and Web of Science, combining key terms regarding recent infectious disease outbreaks and psychological and coping responses. Papers published from database inception to April 20, 2020, were considered for inclusion. Only studies in the English language and papers from peer-reviewed journals were included. We identified 95 (PubMed) and 49 papers (Web of Science) from the database search, of which 23 papers were eventually included in the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for data extraction. The McMaster University critical appraisal tool was used to appraise quantitative studies. Guidelines by Higginbotham and colleagues were used to appraise qualitative studies. Only studies exploring the combined psychological and coping responses of HCW amid infectious diseases were included. Salient psychological responses that can persist beyond the outbreaks included anxiety/fears, stigmatization, depression, posttraumatic stress, anger/frustration, grief, and burnout, but also positive growth and transformation. Personal coping methods (such as problem solving, seeking social support, and positive thinking) alongside workplace measures (including infection control and safety, staff support and recognition, and clear communication) were reported to be helpful. Psychological support for HCW in the current COVID-19 pandemic and future outbreaks should focus on both individual (eg, psychoeducation on possible psychological responses, self-care) and institutional (eg, clear communication, providing access to resources for help, recognition of efforts of HCW) measures.

New coronavirus cases and related deaths are continuing to occur worldwide. Early identification of the emergence of novel outbreaks of infectious diseases is critical to the generation of timely responses. We performed a comparative study to determine the feasibility of the early detection of the COVID-19 outbreak in China based on influenza surveillance data and the internet-based Baidu search index to evaluate the timelines of the alert signals compared with the traditional case reporting and response systems. An abnormal increase in the number of influenza-like illnesses (ILI) occurred at least one month earlier than the clinical reports of pneumonia with unknown causes and the conventional monitoring system. The peak of the search volume was 20 days earlier than the issuance of the massive official warning about the epidemic. The findings from this study suggest that monitoring abnormal surges of ILI and identifying peaks of online searches of key terms can provide early signals of novel disease outbreaks. We emphasize the importance of broadening the potential of syndromic surveillance, internet searches, and social media data together with the traditional disease surveillance system to enhance early detection and understanding of emerging infectious diseases.SynopsisEarly identification of the emergence of an outbreak of a novel infectious disease is critical to generating a timely response. The traditional monitoring system is adequate for detecting the outbreak of common diseases; however, it is insufficient for the discovery of novel infectious diseases. In this study, we used COVID-19 as an example to compare the delay time of different tools for identifying disease outbreaks. The results showed that both the abnormal spike in influenza-like illnesses and the peak of online searches of key terms could provide early signals. We emphasize the importance of testing these findings and discussing the broader potential to use syndromic surveillance, internet searches, and social media data together with traditional disease surveillance systems for early detection and understanding of novel emerging infectious diseases.

Early identification of the emergence of an outbreak of a novel infectious disease is critical to generating a timely response. The traditional monitoring system is adequate for detecting the outbreak of common diseases; however, it is insufficient for the discovery of novel infectious diseases. In this study, we used COVID-19 as an example to compare the delay time of different tools for identifying disease outbreaks. The results showed that both the abnormal spike in influenza-like illnesses and the peak of online searches of key terms could provide early signals. We emphasize the importance of testing these findings and discussing the broader potential to use syndromic surveillance, internet searches, and social media data together with traditional disease surveillance systems for early detection and understanding of novel emerging infectious diseases.

In this paper we perform a rapid review of existing mobile-based, open-source systems for infectious disease outbreak data collection and management. Our inclusion criteria were designed to match the PANDORA-ID-NET consortium’s goals for capacity building in sub-Saharan Africa, and to reflect the lessons learned from the 2014–16 West African Ebola outbreak. We found eight candidate systems that satisfy some or most of these criteria, but only one (SORMAS) fulfils all of them. In addition, we outline a number of desirable features that are not currently present in most outbreak management systems.